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Factors Affecting Circuit Life During Continuous Renal Replacement Therapy in Children With Liver Failure
Author(s) -
Goonasekera Chulananda D,
Wang Justin,
Bunchman Timothy E,
Deep Akash
Publication year - 2015
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/1744-9987.12224
Subject(s) - medicine , renal replacement therapy , clotting factor , heparin , catheter , surgery , anesthesia
Despite abnormal clotting, circuits clot during continuous renal replacement therapy ( CRRT ) in children with acute liver failure ( ALF ). We report our experience. All children with ALF needing CRRT were studied over 2 years. Patient and circuit factors associated with circuit use were evaluated. Thirty‐one children in liver failure (median age 7.4 years) underwent CRRT, of which 17 (54.8%) died. A total of 98 filtration episodes were used. The smallest access catheter was 6.5 Fr, while the largest was 13.5 Fr. The most common filter used was HFO 7 (63%). Mean duration ( SD ) of circuit use was 33.13(30.83) hours. Of the 98 filtration episodes, circuits blocked in 25, whereas the access catheter blocked in 25. Fifty‐two circuits were changed electively for a variety of reasons. Prostacyclin was the anticoagulant in 62 filtration episodes. The remaining filtration episodes had either no anticoagulation or heparin. The mean ( SD ) “downtime” was 5.13 (9.15) hours. We found a significant association between fresh frozen plasma ( FFP ) use with circuit blockade. Neither the duration of CRRT nor the “downtime” influenced mortality. The CRRT circuits blocked in children despite deranged clotting in liver disease. Circuits are changed for a variety of reasons other than clotting. The use of FFP reduces circuit life.